New WPATH Standards of Care for Transgender and Gender Diverse/Nonbinary People is released today

[Kelly]

It is version 8 and is here:

 

https://www.tandfonline.com/doi/pdf/10.1080/26895269.2022.2100644

 

The Standards of Care (SoC) from the World Professional Association for Transgender Health (WPATH), of which I am a member, is used to provide care for non-cisgender people. Often considered the gatekeeping rules, they are actually designed to allow health professionals help gender diverse and nonbinary people.

 

Each version is an improvement on the previous one. I was present ten years ago when we released the 7th version in Atlanta. That was a big improvement, and the first to really realize the needs of nonbinary people. This one has a full chapter on nonbinary, which is defined here as:

 

Spoiler

Nonbinary is used as an umbrella term referring
to individuals who experience their gender as
outside of the gender binary. The term nonbinary
is predominantly but not exclusively associated
with global north contexts and may sometimes
be used to describe indigenous and non-Western
genders. The term nonbinary includes people
whose genders are comprised of more than one
gender identity simultaneously or at different
times (e.g., bigender), who do not have a gender
identity or have a neutral gender identity (e.g.,
agender or neutrois), have gender identities that
encompass or blend elements of other genders
(e.g., polygender, demiboy, demigirl), and/or who
have a gender that changes over time (e.g., genderfluid) (Kuper et al., 2014; Richards et al., 2016;
Richards et  al., 2017; Vincent, 2019). Nonbinary
people may identify to varying degrees with
binary-associated genders, e.g., nonbinary man/
woman, or with multiple gender terms, e.g., nonbinary and genderfluid (James et  al., 2016; Kuper
et  al., 2012). Nonbinary also functions as a gender identity in its own right (Vincent, 2020). It
is important to acknowledge this is not an
exhaustive list, the same identities can have different meanings for different people, and the use
of terms can vary over time and by location.

 

This is a jump in the right direction from our previous version.

 

There are better options for trans people, too. In years past, in order to get permission for genital surgery (which we now call gender-affirming surgery rather than sex reassignment surgery), one had to obtain two "letters" from certain qualified professionals. These letters could be difficult to obtain and often required a "real-life test" where one successfully lives as the "opposite" gender for at least a year (without any temporary reversion). Now, one letter "if required" is sufficient (none if not required).

 

If you have a gender professional that is using an older version and said version is not helping as good as it could, share this with them. I hope that this will make your transitions to who you really are easier and that it will help improve peoples' quality of life.

 

[Starry Sky]

Wow ❤️ Thank you for sharing this wonderful news. It great to hear of steps in the right direction when it feels sometimes like we're going backwards. 

[LeChat]

Thank you, for the info!

[Sarah-Sylvia]

Thanks for updating on this, It's really good to know.

 

33 minutes ago, Kelly said:

These letters could be difficult to obtain and often required a "real-life test" where one successfully lives as the "opposite" gender for at least a year (without any temporary reversion). Now, one letter "if required" is sufficient (none if not required).

Did they change the requirement for needing to live as one's identified gender for 1 year?

Because it never made sense. You don't live as your gender by doing something, someone is how they are and it's up to them what it means in their life.

[Broken Doll]

This is good news but it's unfortunately just a small baby step. I feel more awareness is needed but that is more because I'm not quite sure on what they consider NB gender identity. This is either a little bit vague or I'm just way too tired to make sense of it.

[Kelly]

1 hour ago, Sarah-Sylvia said:

 

2 hours ago, Kelly said:

These letters could be difficult to obtain and often required a "real-life test" where one successfully lives as the "opposite" gender for at least a year (without any temporary reversion). Now, one letter "if required" is sufficient (none if not required).

Did they change the requirement for needing to live as one's identified gender for 1 year?

Because it never made sense. You don't live as your gender by doing something, someone is how they are and it's up to them what it means in their life.

That "real-life test" is no longer a requirement. Indeed, it did not make sense and was, in my opinion, problematic. For instance, in years past, genital surgery was required before a legal gender change could be done. That meant that one had to live as "the opposite sex" for over a year with legal gender different from the way that you presented, lived, and worked (and imagine getting stopped by the cops in such instances years ago).

[Sarah-Sylvia]

12 minutes ago, Kelly said:

That "real-life test" is no longer a requirement. Indeed, it did not make sense and was, in my opinion, problematic. For instance, in years past, genital surgery was required before a legal gender change could be done. That meant that one had to live as "the opposite sex" for over a year with legal gender different from the way that you presented, lived, and worked (and imagine getting stopped by the cops in such instances years ago).

That's awesome . I hope this gets reflected in Canadian requirements too.

[Kelly]

7 minutes ago, Sarah-Sylvia said:

19 minutes ago, Kelly said:

That "real-life test" is no longer a requirement. Indeed, it did not make sense and was, in my opinion, problematic. For instance, in years past, genital surgery was required before a legal gender change could be done. That meant that one had to live as "the opposite sex" for over a year with legal gender different from the way that you presented, lived, and worked (and imagine getting stopped by the cops in such instances years ago).

That's awesome . I hope this gets reflected in Canadian requirements too.

WPATH SoC is worldwide.

[Sarah-Sylvia]

14 minutes ago, Kelly said:

WPATH SoC is worldwide.

Right, i meant for how it is in canada and being covered by health care (we have basic surgeries covered, but those requirements were part of it).
Bureaucracy is slow so I don't know really what or how that's gonna go.

[Lysandre, the Star-Crossed]

So here's my question...

Are these just guidelines to help doctors standardize care between different physicians and practices, or are they in some way binding through laws or professional regulatory bodies?

[Sarah-Sylvia]

3 hours ago, Lysandre, the Star-Crossed said:

So here's my question...

Are these just guidelines to help doctors standardize care between different physicians and practices, or are they in some way binding through laws or professional regulatory bodies?

The first part you said. Maybe some use it beyond that, like I mean some regulations get based on them. But there's nothing inherently binding, some places even reject them as standards, even if most use them.

[Kelly]

7 hours ago, Lysandre, the Star-Crossed said:

So here's my question...

Are these just guidelines to help doctors standardize care between different physicians and practices, or are they in some way binding through laws or professional regulatory bodies?

They are guidelines for health care professionals, based on a ton of science, to best treat trans/gender diverse/nonbinary patients. Many places follow them rather well. Some places do not, but I have seen improvement over the years on this.

 

About a year ago, Finland dropped following SoC #7 for trans youth, and now follow a harsher set of rules for (or, I may say, "against") trans youth.

 

Yet Thailand, which used to have very lax laws for treating trans patients, especially for surgeries, passed a national law stating that they would enforce WPATH SoC rules.

 

Other places are improving, too. Canada's once infamous Clarke Institute (now called CAMH) used to use outdated guidelines. They also employed Kenneth Zucker to [mis]treat trans youth by using conversion therapy on the young victims. CAMH has since closed that down. As of today, their website links WPATH SoC #7, which was the latest until yesterday. They may link the new version when they know about it. That is good, as they used to rely on older guidelines.

 

Fenway in Boston used to use rather old versions. On their site today, they use the informed consent model in the WPATH SoC version 7. Previous to that, hormones required six months of psych therapy and a letter. Sometime since version 7, Fenway adopted the new WPATH informed consent guidelines and no longer require the dreaded letter.

 

In some places, the WPATH SoC are law, in other places, not. But as new versions are released, many places do tend to head in the direction of the new versions.

 

If they do not, I hope that the patients can take their cases elsewhere if they can.

[Calligraphette_Coe]

On 9/17/2022 at 12:28 PM, Kelly said:

 

 

Other places are improving, too. Canada's once infamous Clarke Institute (now called CAMH) used to use outdated guidelines. They also employed Kenneth Zucker to [mis]treat trans youth by using conversion therapy on the young victims. CAMH has since closed that down. As of today, their website links WPATH SoC #7, which was the latest until yesterday. They may link the new version when they know about it. That is good, as they used to rely on older guidelines.

Ah! The Bad Ole Days of Jurassic Clarke. One can always date one's self by recalling that name. Nowadays, we have the equivalent of Dune's Butlerian Jihad championed by the Far Right and the House of Trump. History always seemes to repeat itself, and not always in good ways. Nowadays, it's starting to seem like SoC is 'feed them Zoloft and keep the pressure on.'

[Kelly]

On 9/17/2022 at 12:28 PM, Kelly said:

Other places are improving, too. Canada's once infamous Clarke Institute (now called CAMH) used to use outdated guidelines. They also employed Kenneth Zucker to [mis]treat trans youth by using conversion therapy on the young victims. CAMH has since closed that down. As of today, their website links WPATH SoC #7, which was the latest until yesterday. They may link the new version when they know about it. That is good, as they used to rely on older guidelines.

 

Fenway in Boston used to use rather old versions. On their site today, they use the informed consent model in the WPATH SoC version 7. Previous to that, hormones required six months of psych therapy and a letter. Sometime since version 7, Fenway adopted the new WPATH informed consent guidelines and no longer require the dreaded letter.

Bosrton's Fenway now links the new SoC version 8. CAMH Gender Identity Clinic (Adult) (which basically replaced the old Jurassic Clark) still links the old 2011 version 7.

[Kelly]

I will be giving a presentation on the new version at the First Event Trans conference in Boston next month. If you are around, feel free to attend.